Maple Family Dental P.c.

NPI #1487105276 in Horace, North Dakota

Provider Information

NPI Number: 1487105276
Entity Type: Organization
Organization Name: Maple Family Dental P.c.
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Oct 18, 2016
Last Updated: Oct 18, 2016

Practice Location

Address: 594 MAIN ST N
City: Horace
State: North Dakota
ZIP Code: 58047-4640
Phone: (701) 552-6001

Authorized Official

Name: DR. JONATHAN BULTEMA, D.D.S
Title: PRESIDENT
Phone: (701) 552-6001

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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